The derivation of occupational exposure limits in the pharmaceutical industry

Risk assessment studies of the impact of occupational exposure of pharmaceutical workers on the development of antimicrobial drug resistance

Pharmaceutical workers involved with the production of antimicrobial drugs are exposed to various antimicrobial chemicals in different steps of manufacturing such as grinding, sieving, compression, granulation, mixing, and filling. These exposures may lead to the development of multidrug resistance (MDR) in bacteria. Scientific reports on the occupational health hazard of pharmaceutical workers involved in manufacturing antibiotics are scarce. The present study aimed to compare the degree of bacterial resistance in pharmaceutical workers in India to that of individuals not involved in the pharmaceutical field. Twenty male workers from 5 local pharmaceutical companies and 20 male subjects not involved in the pharmaceutical field (non-pharmaceutical subjects) were randomly selected. Nasal fluid and mucus/cough specimens were collected from each subject and were cultured separately at 37 °C for 24 hr to obtain bacterial growth. The cultured species were then identified, isolated, and subjected to microbial sensitivity testing against 18 different antibiotics from 8 different groups by the disk diffusion method. Staphylococcus spp., Pseudomonas spp., and Escherichia coli were identified and isolated from the culture of nasal fluids and mucuses, respectively. All the isolated species of bacteria exhibited significant enhancement of the degree of MDR in pharmaceutical workers compared with non-pharmaceutical subjects. Workers with a longer working history had greater degree of antibiotic resistance and vice versa. It can be certainly considered that the exposure of pharmaceutical workers to antibiotic agents resulted in a high incidence of multidrug resistance. Effective steps should be taken to minimize inherent exposure of pharmaceutical workers to antibiotics during work to prevent antimicrobial drug resistance.

Studies of the impact of occupational exposure of pharmaceutical workers on the development of antimicrobial drug resistance

OBJECTIVES

Pharmaceutical workers involved with the production of antimicrobial drugs are exposed to various antimicrobial chemicals in different steps of manufacturing such as grinding, sieving, compression, granulation, mixing and filling. These exposures may lead to the development of multidrug resistance (MDR) in bacteria. Scientific reports on the occupational health hazard of pharmaceutical workers involved in manufacturing antibiotics are scarce. The present study aimed to compare the degree of bacterial resistance in pharmaceutical workers in Bangladesh to that of individuals not involved in the pharmaceutical field.

METHODS

Twenty male workers from five local pharmaceutical companies and twenty male subjects not involved in the pharmaceutical field (non-pharmaceutical subjects) were randomly selected. Nasal fluid, mucus/cough and stool specimens were collected from each subject and were cultured separately at 37°C for 24 hours to obtain bacterial growth. The cultured species were then identified, isolated and subjected to microbial sensitivity testing against 18 different antibiotics from eight different groups by the disk diffusion method. Staphylococcus spp., Pseudomonas spp. and Escherichia coli were identified and isolated from the culture of nasal fluids, mucuses and stools, respectively.

RESULTS

All the isolated species of bacteria exhibited significant enhancement of the degree of MDR in pharmaceutical workers compared with non-pharmaceutical subjects. Workers with a longer working history had greater degree of antibiotic resistance and vice versa. It can be certainly considered that the exposure of pharmaceutical workers to antibiotic agents resulted in a high incidence of multidrug resistance.

CONCLUSIONS

Effective steps should be taken to minimize inherent exposure of pharmaceutical workers to antibiotics during work to prevent antimicrobial drug resistance.

Occupational exposure standards for pharmaceutical agents

Compared to the wide range of occupational exposure standards available in different countries for industrial chemicals, there are only a few similar standards set for pharmaceutical agents. These substances produce physiological effects in relatively small doses, and there are documented ill-effects from worker exposures, hence the need for such standards. There are different approaches to setting occupational exposure standards for pharmaceutical agents. One derived from the nuisance dust standard may be used, although that may not be wholly appropriate. An approach has been previously suggested for ethinyl estradiol, and this requires the minimal effective dose, a safety factor, an assumption of equal absorption by inhalation as by the oral route, and the volume of air inhaled over an 8-hour day. Toxicological and pharmacological information for zeranol, an animal growth promoter with estrogenic properties, is used with these criteria to obtain an airborne standard. It can be shown that depending on what assumptions are made, there can be more than a tenfold difference in standards reached. There are other difficulties with setting standards for pharmaceutical agents, depending on the group of substances involved. Airborne standards are useful for medicines that are inhaled. A "skin" notation may be needed for those that can be absorbed via the dermal route. Biological standards should also be considered. Provision of standards for pharmaceutical agents will go some way towards protecting exposed pharmaceutical workers.